Journal of pain and symptom management · 2026
Palliative Care Awareness and Misconceptions By Sexual Orientation: HINTS 2018 and 2024.
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Hu Jiamin, Hong Young-Rock, Xie Zhigang
Аннотация
INTRODUCTION: Sexual minority individuals with serious illness experience persistent inequities in end-of-life care compared with their heterosexual counterparts, including reduced access to timely, high-value palliative care (PC). This study examined differences in PC awareness and misconceptions between U.S. sexual minority (lesbian, gay, and bisexual) and heterosexual adults.
METHODS: We analyzed nationally representative data from the 2018 Health Information National Trends Survey (HINTS) Cycle 2 and the 2024 HINTS 7. Sequential multivariable robust Poisson regression models were used to estimate prevalence ratios (PRs) for PC awareness and misconceptions. Models were progressively adjusted: Model 1 (unadjusted); Model 2 (demographics); Model 3 (demographics and socioeconomic factors); and Model 4 (demographics, socioeconomic, and health-related factors).
RESULTS: The final analytic sample included 8,036 respondents, of whom 6.5% self-identified as sexual minorities. The prevalence of PC awareness was 44.5% among sexual minority adults and 39.6% among heterosexual adults (P = 0.29). Although unadjusted differences were not statistically significant, sexual minority adults demonstrated significantly higher PC awareness after adjustment for socioeconomic factors (Model 3: adjusted PR [aPR] = 1.23; 95% CI: 1.03-1.47) and health-related factors (Model 4: Apr = 1.22; 95% CI: 1.02-1.46). Among respondents reporting PC awareness, 20.5% of sexual minority adults and 23.1% of heterosexual adults reported PC misconceptions (P = 0.65), with no significant differences observed across all regression models.
CONCLUSIONS: After accounting for socioeconomic and health-related differences, sexual minority adults demonstrated higher PC awareness but comparable levels of PC misconception relative to heterosexual adults. Future research should examine mechanisms underlying the PC awareness-utilization gap among sexual minority populations.
METHODS: We analyzed nationally representative data from the 2018 Health Information National Trends Survey (HINTS) Cycle 2 and the 2024 HINTS 7. Sequential multivariable robust Poisson regression models were used to estimate prevalence ratios (PRs) for PC awareness and misconceptions. Models were progressively adjusted: Model 1 (unadjusted); Model 2 (demographics); Model 3 (demographics and socioeconomic factors); and Model 4 (demographics, socioeconomic, and health-related factors).
RESULTS: The final analytic sample included 8,036 respondents, of whom 6.5% self-identified as sexual minorities. The prevalence of PC awareness was 44.5% among sexual minority adults and 39.6% among heterosexual adults (P = 0.29). Although unadjusted differences were not statistically significant, sexual minority adults demonstrated significantly higher PC awareness after adjustment for socioeconomic factors (Model 3: adjusted PR [aPR] = 1.23; 95% CI: 1.03-1.47) and health-related factors (Model 4: Apr = 1.22; 95% CI: 1.02-1.46). Among respondents reporting PC awareness, 20.5% of sexual minority adults and 23.1% of heterosexual adults reported PC misconceptions (P = 0.65), with no significant differences observed across all regression models.
CONCLUSIONS: After accounting for socioeconomic and health-related differences, sexual minority adults demonstrated higher PC awareness but comparable levels of PC misconception relative to heterosexual adults. Future research should examine mechanisms underlying the PC awareness-utilization gap among sexual minority populations.